Sciatic Nerve Schwannoma

Rekha, Arcot; Annamalai, Radha

doi:10.1177/1534734604268094

Cited by 28 publications

(26 citation statements)

References 7 publications

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“…Since the symptoms are similar to sciatica due to a herniated disk, while imaging of the spine may reveal discopathy, intrapelvic MPNST of the sciatic nerve is easily misdiagnosed (8,9). A misinterpretation of the findings may result in incorrect treatment by discectomy, as reported in our patient.…”

Section: Discussionmentioning

confidence: 70%

Giant intrapelvic malignant peripheral nerve sheath tumor mimicking disc herniation: A case report

Wang

Chen

Xin

et al. 2016

Molecular and Clinical Oncology

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Abstract. Giant intrapelvic malignant peripheral nerve sheath tumors arising in the sciatic nerve in the pelvic cavity are a rare occurrence and their symptomatology is usually misdiagnosed as intervertebral disc herniation. We herein report the case of a 46-year old woman presenting with pain, hypesthesia and weakness of the left lower extremity due to a giant intrapelvic malignant peripheral nerve sheath tumor of the sciatic nerve. Prior to being referred to our institution, the patient was misdiagnosed as a case of sciatica due to a lumbar disc herniation and underwent an operation unsuccessfully, as there was little symptomatic improvement 2 months after the surgery. A magnetic resonance imaging examination of the pelvic cavity revealed a tumor of the sciatic nerve. The mass was resected via the posterior approach and histopathological examination confirmed the diagnosis of malignant peripheral nerve sheath tumor. Intrapelvic malignant peripheral nerve sheath tumors are an uncommon cause of sciatica and are commonly misdiagnosed as lumbar intervertebral disc herniation. Accurate diagnosis and complete surgical excision prior to metastasis are crucial for effective management of this condition. IntroductionThe most common cause of sciatica is intervertebral disc herniation; thus, obscure causes are rarely considered in the differential diagnosis. Malignant peripheral nerve sheath tumor (MPNST) arising from the sciatic nerve is a relatively rare malignant soft tissue tumor (1). This tumor may produce severe radicular pain and sensorimotor deficits, mimicking a disc herniation. Due to the rare incidence of this disease, reports on intrapelvic MPNSTs are scarce and there has been no systemic study of intrapelvic MPNSTs to date (2,3). In this study, we reported a misdiagnosed case of giant intrapelvic MPNST of the sciatic nerve mimicking disc herniation. Our aim was raise awareness that intrapelvic MPNST is an unusual cause of sciatica, which is usually misdiagnosed as disc herniation. The diagnosis, treatment and prognosis of MPNSTs were also discussed. Case reportA 46-year old woman was admitted to another hospital with a 3-month history of pain that radiated from the posterior aspect of the left thigh to the lateral aspect of the leg and left foot, and was associated with numbness of the left lower limb. The patient had undergone a lumbar magnetic resonance imaging (MRI) examination, which revealed a mild L4/5 intervertebral disk herniation (Fig. 1A and B). A clinical diagnosis of intervertebral disk herniation was made, and L4/5 discectomy was performed (Fig. 1C and D). However, there was little symptomatic improvement after 2 months. The patient was subsequently referred to our institution.On admission, the patient's neurological examination revealed grade 3/5 weakness of the quadriceps femoris, grade 2/5 weakness of the triceps surae and grade 0/5 weakness of the extensor hallucis longus and extensor digitorum longus, a decreased sensation to light touch, decreased patellar reflex and Achilles reflex on the...

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Section: Discussionmentioning

confidence: 70%

Giant intrapelvic malignant peripheral nerve sheath tumor mimicking disc herniation: A case report

Wang

Chen

Xin

et al. 2016

Molecular and Clinical Oncology

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“…2,10,12,16 Surgical excision is the treatment of choice. Schwannomas are theoretically removable since they repulse fascicular groups without penetrating them thus allowing their enucleation while preserving nerve continuity, 8,11,14,15 as reported in our patient. Microsurgical excision should be performed using electrical stimulation to facilitate detection of motor fascicles.…”

Section: Discussionmentioning

confidence: 91%

“…The most common clinical presentation of sciatic nerve schwannoma consists of a painful palpable mass. 9,11,13 Schwannomas most commonly occur in adults between 20 and 50 years of age. Schwannomas are usually homogeneous on both T1-and T2-weighted images but a neurofibroma is usually heterogeneous.…”

Section: Discussionmentioning

confidence: 99%

“…Schwannomas most commonly are observed in adults between 20 and 50 years old. 11,13 We report a very rare case of giant schwannoma of the sciatic nerve in a 19-year-old female who presented with increasing swelling and discomfort in the posterior aspect of her right thigh. The surgical excision was delayed for 2 years due to lack of proper diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Neglected Giant Schwannoma of the Sciatic Nerve. Case Report and Literature Review

ElEmam

Hasan

Elsebaey

2018

Egyptian Spine Journal

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Background Data: Schwannomas originating from the sciatic nerve are extremely rare and usually present as a pathological mass on palpable examination or pain located in the thigh. Motor and sensory deficits are observed more often with big size lesions. Purpose: To describe a rare case of giant schwannoma of the sciatic nerve with 2 years delay in management. Study Design: Case report and review of the literature. Patients and Methods: A 19-years-old female patient was referred to Suez Canal University Hospital after 6 years of pain and 2 years of improper management. She presented with increasing swelling in the posterior aspect of her right thigh associated with paresthesia and weakness. After neurological examination an MRI of the right thigh was done and revealed huge mass attached to the right sciatic nerve. Results: Surgical excision was undertaken, carefully dissecting the lesion from the sciatic nerve. Histopathological examination revealed a sciatic nerve schwannoma. The patient had marked postoperative recovery with marked pain reduction and improved neurological deficits. Conclusion: Schwannomas of the sciatic nerve are eccentrically located on the nerve. they should be systematically suspected if thigh mass or persistent sciatica is reported. Surgical excision has good prognosis. (2018ESJ157)

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“…Malignant schwannoma constitute 2% of the nerve sheath tumors and they have a predilection for larger diameter peripheral nerves such as brachial plexus or Sciatic nerve. Malignant transformation of benign schwannomas is unusual [16].The slow growth pattern of the tumor allows for the adaptation of the nerve function to the pressure effects which leads to the delayed presentation and diagnosis [17].Schwannomas of the median nerve are rare tumors.They occur commonly in the distal region of the upper extremity (at elbow or distal), occurs more in the mixed nerves. Two types of presentation are seen.…”

Section: Schwannomasmentioning

confidence: 99%

Ancient schwannoma of the median nerve-a case report and review of the literature of nerve tumors

Mariappan¹

2014

IOSRJDMS

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Sciatic Nerve Schwannoma

Abstract: Schwannomas are benign tumors of the nerve sheath, commonly seen in the vestibular nerve. Although they are common in the head and neck areas, their occurrence in extra-cranial locations is rare. We report a case of a sciatic nerve schwannoma and review the literature.

Cited by 28 publications

References 7 publications

Giant intrapelvic malignant peripheral nerve sheath tumor mimicking disc herniation: A case report

Giant intrapelvic malignant peripheral nerve sheath tumor mimicking disc herniation: A case report

Neglected Giant Schwannoma of the Sciatic Nerve. Case Report and Literature Review

Ancient schwannoma of the median nerve-a case report and review of the literature of nerve tumors

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